Reflection based on Gibbs reflective cycle (Example 1)

Gibbs, G. (1988) Learning by doing. A guide to teaching and learning methods. Oxford Polytechnic:

Oxford

Description – what happened?

A patient that I had been looking after for many years with cystic fibrosis finally died on my ward.

Feelings – what were you thinking and feeling?

Intellectually, I thought that she had lived longer than we would ever have thought possible at the

time of her diagnosis in early childhood. Emotionally, I was shocked, even though I have seen so

many CF patients die over the years. Somehow this one had got under my skin. I wasn’t ready for her

to die and she should not have died then, of sepsis.

Evaluation – what was good and bad about the experience? What went well and what went badly?

She had lived her life as if every moment could be her last and I am sure she had no regrets. Her last

few hours were peaceful, and I am sure that she did not suffer. Her family were all able to be with

her when she died as we had an appropriate side-room available. I still think she should not have

ended up with an overwhelming sepsis from (I presume) an infected insect bite or scratch from the

garden. Her initial symptoms were so non-specific – I thought it was another chest infection. She

wanted to die at home and that was not possible.

Analysis – what sense can you make of the situation?

Any patient with long-standing CF and multiple transplants is vulnerable. The immune suppression is

always a risk. I doubt that this patient had very long left to live anyway as her admissions were

becoming more frequent. On reflection, this was not as unexpected as it felt.

Conclusion – what else could you have done?

I am not sure that there is anything else that we could have done that would have affected the

outcome. I was upset about being upset and felt that I should not have felt shocked which is why I

chose to bring this case to my appraisal.

Action plan – if it arose again, what would you do?

This will arise again. It has happened many times in my career that patients die when I think they

should not. Talking this through with my appraiser, I have learned to be kinder to myself and to

recognise that it is OK to grieve on those occasions and to give myself time to do so.

#4- Example of Gibbs Model of Reflection

1. Description:

Let’s take an uncomfortable experience from a pilot for a rented plane, a special pilot for tourism
passengers. At that time, the customer has a special request to get a tour above a big special island to
enjoy the scenery.

2. Feelings:

Everything was going right and beautifully at first because they enjoyed many waterfalls scenery. Until
they faced an uncomfortable experience when they tried to fly higher and at the point of at least 7000 ft
off the water’s surface. And everybody starts screaming and yelling especially the kids.

3. Evaluation:

They are rules that need to follow and knowledge that need to be used. As a pilot, it should be right to
use his own consideration whenever facing difficult situations. Keeping calm and focused will be the
most important element to hold on to in crisis situations. Risks sometimes trigger fun situations;
however, they will not be good options to take especially for strange or unfamiliar routes.

4. Analysis:

This event is important to take as a special experience to be an expert. It can teach many things and how
to deal with difficult situations. The real experience that happens in the air will be a good teacher for the
next similar situation.

5. Conclusion:

A pilot is one of the pillars of the aviation industry. Their job is very interesting however, they have high
responsibility and need to be fully knowledgeable with all regulations to make passengers and cargo
safely reach their destination. And it is very important for the pilot to use his own knowledge to do the
job. In this case, don’t blindly accept and follow passenger requests even if they book the plane at a
special price or because they are important passengers.

6. Action Plan:Be familiar with the plane that will be used, check everything related to the route, and
distribute the rules to the passenger to avoid any unusual requests while in the air. These actions will
prevent the pilot from facing a similar uncomfortable experience in the future.
#1- Example of Atkins and Murphy Model of Reflection

1. Awareness:

Let’s get an example from a CFO of a famous luxury hotel. He gets an uncomfortable experience related
to asset cost. It is well-known that fixed assets of a hotel business will usually have high prices. Some of
the examples from the list are land, building, machinery and equipment, office equipment, vehicles, and
software.

2. Describe:

At that specific time around two years before, he lacked to predict or prepare a budget for a new hotel
software related to an accounting software system. This kind of software would be a hotel asset and
very advance because it will help to smooth the hotel’s operating system.

3. Analyse:

He analyses the case, and if he can predict this expense before and put it in the budget then he will not
need to face a crowded and rush system in the hotel’s high season.

4. Evaluate:

After analysing several similar scenarios that could happen now or in the future. Now, he evaluates
some unpredictable costs that could happen in the future. It is not just related to accounting fixed costs
itself, but almost all other expenses related to software updates, market situations, and government
rules. All these elements are unstable and need special attention.

5. Identify:

This CFO learns from his previous uncomfortable experience to create some special budget posts for
some unpredictable assets, and he also increases the budget percentage for software expenses in order
to avoid the same uncomfortable experience in the future. Now, after setting up some appropriate
action he can be sure that he will not face uncomfortable situations again and will be more ready for the
future.
Atkins and Murphy's model of reflection example in
nursing
Case assessment - This reflective example will highlight the experience of a
nurse who faces the challenge of getting emotionally attached to the patient.
This reflection will focus on her challenges and the ways in which she dealt with
the issue of emotional attachment.

Stage 1: Self-awareness
Which occurrences had a major effect on your emotions?
It's been almost a week since I joined nursing health care and I am quite nervous about
starting a career I always wanted to be in. But I always had one fear that intrigued me
when I had to tell someone's relatives that their close ones are no more. Although it's
part of my job, somehow, I always felt that it would be so disheartening for people to
know that they will never see their loved ones smiling again.

What were you thinking at the time of the situation?

When the incident happened, when I actually had to encounter my biggest fear, I
experienced goosebumps in my whole body and I actually shivered out of anxiety.

What exactly were your feelings right after the situation occurred?
After I told the father that their son was no more, he broke into tears in front of my eyes
which made me nervous and anxious.

What are your feelings right now about the situation you are reflecting
upon?
Even thinking of the time right now gives me chills down my throat that it could be so
disheartening to deliver this message to someone.

Stage 2: Describe
What, where, when, and why did things happen the way they did?
Christen was a third-stage colorectal cancer patient and I was in charge of his dressing
and other essential needs. Stage 3 colon cancer is when a mass of cells also known as a
tumor spreads or metastasizes beyond the lining of the colon to nearby nodes of lymph
(Myhre & Sifris, 2022). Christen was one of the most delightful people I have ever met in
my life. He used to dance, make us all laugh, and kept himself busy every single day. He
never made us feel like he was a third-year cancer patient and his chances of survival
were minimal. Then, it was a regular chemo day for Christen, before going in he
promised that after coming back, we would do the jigsaw puzzle together. But that day,
there were some extra complications and doctors found that the infection in Christen's
body was spreading like wildfire.

What was your contribution to the situation?

That was the reason doctors were not able to save Christen that day. Besides, me, being
in charge now, had to inform his parents that we had lost him. I called his father and his
first question was how is Christen?' I didn't want to give him the news over the phone,
so I asked him to reach the hospital as soon as possible. As he arrived, I explained
everything to him and his father broke down listening to the fact that his 25-year-old
Christen was no longer with us.

How other factors and elements were involved?

During this situation, the environment of the hospital was quite negative because there
were 4 sudden deaths in our department. This even made the situation worse.

Stage 3: Analyze
What were your previous assumptions about the situation?
If I think about my college time and remember the time when I used to assume this
moment, I always thought that it would be difficult.

What was the actual reality of the situation?

In reality, I realized that it was not at all easy to break the news to somebody's parents
that their loved ones would not be with them for the rest of their lives.

What was the difference between your assumptions and reality?

But the difference here between my assumption and reality is that I never thought that
we as nurses in-charge would get so attached to the patients and although the pain
would not be equal to the pain of family, we would still feel hurt.

Stage 4: Evaluation
What knowledge did you get from your analysis?
From the above incident, I know that this is going to happen a million times in my life
again and now I will have two choices every time. Either I can break down like I did this
time or I can work on this and start getting strong.

How are you going to use this knowledge in the next instances?
After effectively gaining from this experience, I got to know that making myself stronger
will only help me in getting the efficient energy to break down the news.

Stage 5: Identify
What have you learned so far?
From this incident, I identified that being a nurse is not an easy option and it is human
nature to get attached to a person you take care of 24/7. But I also identified that
getting attached too much to a patient will never benefit my peace of mind (Young,
2020). Hence, it is essential to take care of the patient because that is my primary duty
but I also need to ensure that I don't get attached mentally to a patient as I did with
Cristen because it will only make it difficult for me.

How will you use this learning in future similar situations?

In the future, I will make sure that I will not get emotionally attached to the patients
from the next time. To prevent that emotional connection, I will ensure to avoid getting
indulge in personal communication with the patient of any sort. However, this in no way
applies that I will decrease the quality of service that I will provide to the patient. I will
just ensure that the emotional attachment with the patient is low.